China's Tu Youyou discovered an anti-malarial drug from a herb, which she found cited in a 4th century Traditional Chinese medicine (TCM) document as a fever treatment. She derived artemisinin from sweet wormwood, which could be a crucial weapon in the global fight against the mosquito-borne disease as resistance to other treatments spread. As Tu collects her country's first Nobel Prize for medicine next week, this award has prompted debate over the role of science in the practice.
TCM is a source of cultural pride in some Chinese quarters, with Beijing planning to expand its provision, and even Premier Li Keqiang seized on the Nobel award, hailing Tu's discovery as a great contribution of TCM to the cause of human health.
But Nobel committee member Hans Forssberg was adamant, "It's very important that we are not giving a prize to the traditional medicine. The award was only for scientific work that had been inspired by it."
TCM is based on a set of beliefs about human biology, including the existence of a life force,'qi', and that illness is the result of 'imbalances' between the five elements - fire, water, earth, metal and wood - in the system.
Tu chemically extracted the active ingredient of a single plant in isolation.
Lan Jirui, who has a booming TCM private practice in Beijing, said, "Many fear that the recent Nobel Prize, which celebrates westernized Chinese medicine, will end up doing more harm than good for authentic traditional medical practice. You should not use Western science to 'cure' Chinese medicin., The study of TCM from a rationalist perspective is 'essentially hopeless'. The human body is very complicated - you cannot see it only as a machine. The scariest thing is to lack confidence in your own traditions, to allow others to 'update' you, and then destroy what you had."
Many mainstream medicines were originally derived from plants, and some researchers are looking for active ingredients in TCM components, even though Tu failed to find other such drugs despite years of efforts.
Tai-Ping Fan, head of the Chinese Medicine Laboratory at the University of Cambridge, said, "It's good to look into ethnopharmacology. Medicine has evolved since the dawn of humanity, and science. We need to have evidence. But there?s the possibility now, thanks to science, to begin to discuss this problem, how we can see East and West come together."
With no standardized guidelines, TCM can offer radically different diagnoses - based on observation and pulse-taking - for the same symptoms. Similarly, prescriptions are highly variable, made up of multiple herbs, minerals and animal parts - sometimes from endangered species, now officially banned - along with massages, acupuncture and other treatments.
Fan said, "I think it'd be quite good really to find out what is there in rhino horn instead of throwing it all away. Those that have been confiscated can be sent to laboratory and analyzed and synthesized."
TCM is an enormous industry in China, with a total value in excess of $91 billion in 2013, a third of the total output of the country's medical industry. In recent years the government has upped funding and support, even though most health facilities use orthodox medicine, and national healthcare guidelines released in May said every county and municipality should seek to have a dedicated TCM hospital by 2020.